COVID-19 Infection In Patients With Autoimmune Rheumatic Diseases: Patient's Perspective And Descriptive Analysis From A Lower-Middle-Income Country.

The study was conducted to determine the severity of COVID-19 in autoimmune inflammatory rheumatic disease (AIRDs) patients and knowing their perceptions. All AIRDs cases with COVID-19 infection between December 2020 and February 2021 were included. A cross-sectional telephonic survey was conducted for perceptions. Twenty- one patients were analysed for severity of illness and 16(76.2%) for perceptions. Mean age was 44.8±14.8 years, with 11(52.4%) females. Two (9.5%) patients had severe disease, 6(28.6%) required hospitalisation, and none expired. Hypertension 7(33.3%) was the commonest comorbidity. Low dose steroids were the most used drug 9 (42.9%). Regarding perceptions, 10 out of 16 (62.5%) felt that AIRD made them vulnerable to COVID-19 infection. The most common reason of delay in seeking medical advice from the rheumatologist was closure of services for chronic diseases during the pandemic. Patients with AIRDs, receiving immunosuppressive treatment seem to be at a lower risk of developing a severe form of COVID-19 pneumonia.

COVID-19 and thrombotic thrombocytopenic purpura: A case report.

The clinical presentation of COVID-19 varies from being asymptomatic to developing acute respiratory distress syndrome and multi-organ dysfunction. The diffuse microvascular thrombi in multiple organs seen in the autopsy of COVID-19 patients are similar to that of thrombotic microangiopathy (TMA). TMA is characterised by thrombus formation in the microvasculature with laboratory findings of microangiopathic haemolytic anaemia (MAHA) and thrombocytopenia. A 49-year-old male presented to the Aga Khan University Hospital, Karachi. with fever, diarrhoea, altered level of consciousness, and a positive nasopharyngeal swab for SARS-CoV-2. He developed severe thrombocytopenia, MAHA with 5.8% schistocytes, and worsening renal function on the sixth day of admission. Diagnosis of thrombotic thrombocytopenic purpura (TTP) was established based on PLASMIC score, and he was successfully treated with intravenous (IV) Methylprednisolone, therapeutic plasma exchange and IV Rituximab. The case emphasises the need to keep TTP in the differential diagnosis when a patient with COVID-19 develops severe thrombocytopenia, acute renal failure, or impaired level of consciousness, since prompt diagnosis and treatment is necessary to gain favourable outcome.

Correlation of serum calcium with severity of acute ischaemic stroke.

Stroke results in the death of around 6.5 million people annually with a majority of these occurring in developing countries. Serum calcium has been hypothesised to play a significant role in causing ischaemic stroke. This retrospective observational study was conducted to determine the correlation, if any, between serum calcium and the severity of acute ischaemic stroke in our population. Two hundred and seventy-nine patients admitted with acute ischaemic stroke were enrolled in the study. Of the 279 patients 162 (58%) were male and mean age was 62.4 ± 3.8 years. Characteristics of stroke patients were compared with stroke severity. Mean albumin corrected serum calcium and Scandinavian stroke severity score was 9.1 (± 5.6) and 33.67 (± 15.2), respectively. Hypertension and mean GCS on admission were significantly associated with increased stroke severity score. However, no correlation was observed between serum calcium and severity of acute ischaemic stroke.

Cerebral phaeohyphomycosis due to Rhinocladiella mackenziei in an immunocompetent patient: A case report and review of literature.

BACKGROUND AND PURPOSE: Rhinocladiella mackenziei is a neurotropic fungus, which can cause devastating intracerebral infections with up to 100% fatality rate. It is difficult to isolate this fungus in laboratory as it grows slowly and requires diagnostic skills. CASE REPORT: A 42-year-old Pakistani man presented with headache, facial numbness, progressive upper limb weakness, and dysarthria. Magnetic resonance imaging of the brain showed a space-occupying lesion in the basal ganglia region. The patient underwent supratentorial craniotomy for biopsy and excision. Histopathology of the specimen revealed granulomatous inflammation with abscess formation. Periodic acid- Schiff special stains highlighted the presence of numerous septate fungal hyphae. The results revealed the growth of dematiaceous fungi, which were morphologically classified as R. mackenziei. The patient is currently stable and is being on amphotericin and posaconazole, along with neurorehabilitation therapy. CONCLUSION: Rhinocladiella mackenziei brain abscess is a devastating infection with significant mortality. This condition should be suspected in patients with brain abscess from high endemic areas.

Essential minerals and phytic acid in legumes with reference to their nutritive and medicinal properties.

Three commonly used legumes, Macrotyloma uniflorum (Lam.) Verdc., Phaseolus lunatus Linn., and Phaseolus vulgaris Linn., were subjected to determine their minerals and phytic acid contents to correlate their nutritional and medicinal properties. To quantify essential minerals, atomic absorption spectroscopic method, while for phytic acid estimation, spectrophotometric method was used. Presence of Fe, Mg, Mn, P and Zn were recorded in good quantities, Ca and Cu in moderate, while K in small quantity in the seed flours of all the three tested legumes. Maximum Fe and Zn content (0.38 and 0.40 mg/g) were recorded in P. vulgaris, while M. uniflorum delivered high content of Mg, Mn, P and Ca (0.21, 0.20, 77.94 and 0.04 mg/g) and 0.04 mg/g Cu was recorded in P. lunatus. The highest level of phytic acid (37.00 mg/g) was recorded in M. uniflorum at 519 nm. The estimated quantities of minerals and phytic acid provide a good opportunity to draw a conclusion that all the three tested legumes could potentially be used as food to achieve nutritional and health related functional benefits.